Computerized Healthcare Systems: Improving Quality and Accessibility

NUT 724. 4. 3-01-08 (name) Western Governors University NUT 724. 4. 3-01-08 Health care costs are rising, quality of care is declining, lines and waiting times are getting longer which is causing more errors in healthcare. But the healthcare reform is working on changing all of that and bringing the countries healthcare into the 21st century. This paper will explore how computerized healthcare systems increase quality of care, keep patient information accessible yet safe, the challenges on costs, and will compare two separate systems and evaluate each with a recommendation of one for use.

Quality of care is important for anyone who accesses the healthcare system. This can become difficult when patients are seen in different healthcare systems, or even from the primary care setting to the hospital setting. Computerized management systems (CMS) make a patients visit to any area safer. Any provider with access can see all of the patient’s records at any given time and in an organized fashion. Providers will have prior tests, medications, and past medical history all at their fingertips to provide more accurate care and quicker care.

All of this will lead to fewer mistakes and quicker diagnosis. If continuity of care is increased, quality of care will also be increased. Nursing involvement in the development of CMS is extremely important. The ratio of nurses to any other hospital staff using the system is much greater, thus nursing should have the biggest influence on planning and use. Nursing staff is well aware of any faults with paper records as many hours are spent on clinical documentation and not on patient care (Rein, 2011, para. 3).

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Nursing staff is also on the ‘frontline’ listening to the complaints and concerns from patients. They know what it would take to improve the communities view on healthcare. Nurses are also the ones who can convey a more positive attitude about the system if they have been involved in design and implementation. A Harris poll in 1999 showed that “92 percent of the public said they trust information about health care provided by registered nurses, ranking nurses just 1 percentage point below physicians” (Rein, 2011, para. 9).

Handheld devices used with CMS can optimize care given to patients because patient information can be accessed anytime and anywhere via wireless technology. A hardwired computer is not needed in order to access the information. Quality of care is improved because of even quicker access to records, tests, and labs. PDA use can not only streamline nursing, but also give them access to electronic resources to increase efficiency and reduce errors (Johnson, 2008, para. 16). Security is a big concern when it comes to computerized patient records.

Prior to the Health and Insurance Portability and Accountability Act ("HIPAA") from 1996, there were few standards in place to protect health information ("HIPPA," 2013, para. 1) In 2006, congress passed the Health Information Technology for Economic and Clinical Health ("HITECH") Act, which applied more severe punishment for HIPPA violations ("HIPPA," 2013, para. 3) Institutions have to go to great lengths to ensure patient information remains safe and secure. Policies and procedures must be in effect and then employees must be held accountable to them.

Access to records must be controlled. Only those who need to have access should be able to access records. Unique user identification methods should be in place to maintain this and they should have automatic log off timing to prevent unauthorized persons from seeing records. Institutions should also perform routine audits of accesses in order to prevent HIPPA violations. This should include network security audits and risk assessments. Mobile devices are also being used more and these devices should be encrypted.

Complying with HIPPA standards maintains trust and prevents breaches of information ("HIPPA," 2013, para. 5). EMR is a costly project costing possibly hundreds of thousands of dollars spent on licenses, hardware, implementation, and support and maintenance ("EMR benefits," 2012, para. 10). While the upfront costs are quite large, the later benefits are huge. EMR is essentially a paperless system, therefore, reducing the paper need of an institution to near zero percent. This alone can save upwards of thousands of dollars a month ("EMR system cost," 2011, para. 2).

Productivity will also be increased due to more streamlined and organized processes with many tasks being automatically done by the EMR ("EMR system cost," 2011, para. 2). Even though implementing EMR will essentially cut down on medical errors and improve efficiency, there are two areas that are of main concern with regards to cost: improved billing and internal cost control (Haig, 2009, p. 2). The biggest problem with EMRs will be to maintain the same level of care and not compromise care as a result of cost effectiveness. EMR Comparison (http://ehr-software. indthebest. com/compare/76-224/Centricity-EMR-vs-EpicCare-Inpatient-Core-EMR-Spring-2008) Centricity EMRvs. Epic (core EMR spring 2008) Platform Mobile Phone/Device? x Web Based? x Supported Architectures? ? Client/Server? ? Mobile Devices? ? Web Services? x Hosting Model Application Service/SaaS? x Customer Hostedx ? Specialty Allergy/Immunology? x Cardiology? ? Dermatology? x Emergency Medicine? x Endocrinology? x Gastroenterology? x General Surgery? x Hematology/Oncology? x Infectious Disease? x Internal Medicine? x Nephrology? x Neurology? x

OB-GYN + x Orthopedic Surgery? x Pediatrics x ? Podiatry ? ? Psychiatryx ? Pulmonology? x Radiology? x Urology ? x Practice Size any any EMR Features Chart management? ? Electronic prescribing? x Patient portal? x Reminders? x Report Management? x Workflow? x Security Features Automatic Logoff? x Backup ? x Emergency Access? x Encrypted data transfer? x Password Protection? x Support Brochures? x Email ? ? Forums ? x Online ? ? Phone x ? System Upgrades? x Yes = + No = x Based on the chart above, Centricity would be recommended for implementation.

As shown, Centricity has many more features and would be very helpful when used by specialty areas. They would be able to create and chart based on their needs, not just the general forms used by the whole hospital. The security features are also a plus when considering meaningful use and HIPPA regulations. Centricity also offers many options when it comes to support which will be especially beneficial during the planning and implementation phases. Overall it would be very difficult to get a system that has everything one institution needs with nothing extra.

There is no such thing as an exact fit. But Centricity does seem to have the most options available to get the best fit. References EMR Benefits and Return on Investment Categories. (2012). Retrieved from http://www. informatics-review. com/wiki/index. php/EMR_Benefits_and_Return_on_Investment_Categories EMR system: Cost effective and financially beneficial for the medical practice. (2011). Retrieved from http://www. medi101. com/2011/08/emr-system-cost-effective-and-financially-beneficial-for-the-medical-practice/ HIPAA Compliance and Data Protection. (2013). Retrieved from http://www. intronis. om/resources/whitepapers/HIPAA-compliance. php Haig, S. (2009, March 5). Electronic Medical Records: Will They Really Cut Costs? []. Time. Retrieved from http://www. time. com/time/health/article/0,8599,1883002-2,00. html Johnson, C. (2008). Nurses and the Use of Personal Digital Assistants (PDAs) at the Point of Care. Scroll, Essays on the Design of Electronic Text. Toronto, Canada. Rein, A. (2011, December 6). Early and Often: Engaging Nurses in Health IT [Blog post]. Retrieved from http://www. rwjf. org/en/blogs/human-capital-blog/2011/12/early-and-often-engaging-nurses-in-health-it. html

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